Other national guidance and current policy documents have been referenced during the development of this quality standard. It is important that the quality standard is considered by commissioners, providers, health and social care professionals, patients, service users and carers alongside the documents listed in Development sources.
NICE has produced a commissioning support document that considers the commissioning implications and potential resource impact of this quality standard. This is available on the NICE website. Information for patients about using the quality standard is also available on the NICE website.
The quality measures accompanying the quality statements aim to improve the structure, processes and outcomes of healthcare in areas identified as needing quality improvement. They are not a new set of targets or mandatory indicators for performance management.
Expected levels of achievement for quality measures are not specified. Quality standards are intended to drive up the quality of care, so achievement levels of 100% should be aspired to (or 0% if the quality statement states that something should not be done). However, NICE recognises that this may not always be appropriate in practice when taking account of safety, choice and professional judgement and so desired levels of achievement should be defined locally.
We have illustrated where national indicators currently exist and measure the quality statement. National indicators include those developed by the Health and Social Care Information Centre through its Indicators for Quality Improvement Programme. If national quality indicators do not exist, the quality measures should form the basis of audit criteria developed and used locally to improve the quality of care.
For further information, including guidance on using quality measures, please see What makes up a NICE quality standard?
During the development of this quality standard, equality issues have been considered. Equality assessments are available.
Good communication between healthcare professionals and women who need or request a caesarean section is essential. Treatment and care, and the information given about it, should be culturally appropriate. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. Women who need or request a caesarean section should have access to an interpreter or advocate if needed.
Commissioners and providers should aim to achieve the quality standard in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this quality standard should be interpreted in a way that would be inconsistent with compliance with those duties.